TNM staging of foregut (neuro)endocrine tumors: a consensus proposal including a grading system

Virchows Arch. 2006 Oct;449(4):395-401. doi: 10.1007/s00428-006-0250-1. Epub 2006 Sep 12.


The need for standards in the management of patients with endocrine tumors of the digestive system prompted the European Neuroendocrine Tumor Society (ENETS) to organize a first Consensus Conference, which was held in Frascati (Rome) and was based on the recently published ENETS guidelines on the diagnosis and treatment of digestive neuroendocrine tumors (NET). Here, we report the tumor-node-metastasis proposal for foregut NETs of the stomach, duodenum, and pancreas that was designed, discussed, and consensually approved at this conference. In addition, we report the proposal for a working formulation for the grading of digestive NETs based on mitotic count and Ki-67 index. This proposal, which needs to be validated, is meant to help clinicians in the stratification, treatment, and follow-up of patients.

Publication types

  • Consensus Development Conference
  • Multicenter Study
  • Practice Guideline
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomarkers, Tumor / analysis
  • Digestive System Neoplasms / chemistry
  • Digestive System Neoplasms / classification
  • Digestive System Neoplasms / diagnosis*
  • Humans
  • Lymph Nodes / chemistry
  • Lymph Nodes / pathology
  • Mitotic Index
  • Neoplasm Metastasis / diagnosis
  • Neoplasm Staging / methods*
  • Neoplasm Staging / standards
  • Neuroendocrine Tumors / chemistry
  • Neuroendocrine Tumors / classification
  • Neuroendocrine Tumors / diagnosis*


  • Biomarkers, Tumor